If we allowed any type of experimentation on dying patients as long as there was consent, dying patients would end up getting used as a Guineapigs by companies trying to get a lucky indication. It would certainly benefit the families left behind financially, but it would not be pretty. “Here’s a million bucks, please take these 40 drugs that will certainly kill you, but we’ll learn which one we should continue with”. And why even do toxicity studies or phase 1 and 2 trials? It’s cheaper to pay of poor people who are on the verge of dying and just pushing them over the edge.

The decision should be just because a patient and a doctor, because the consequences of such decisions are more far reaching than just those two. We have a well established framework for what a drug needs to prove before they can reasonable be allowed to be given to any human being, no matter their situation, and that barrier of entry is there for a multitude of good reasons. Discarding it just because a specific patient is at risk of dying or because you can get consent is not helping patients.

> It would certainly benefit the families left behind financially, but it would not be pretty.

You are very optimistic. Medics will sell expensive snake oil treatment to desperate families. For example, from the bottom of https://en.wikipedia.org/wiki/Breast_cancer#History

> In the 1980s and 1990s, thousands of women who had successfully completed standard treatment then demanded and received high-dose bone marrow transplants, thinking this would lead to better long-term survival. However, it proved completely ineffective, and 15–20% of women died because of the brutal treatment.

> You are very optimistic. Medics will sell expensive snake oil treatment

I think you misunderstood. My point was that it would benefit the families because a company would gladly pay a million bucks to give a dying cancer patient the first human dose of 40 drugs they haven’t yet done any testing on, just to get quick human feedback.

The “patient” in that scenario won’t likely get any benefit from the money, but the family they leave behind would.

Obviously this is not something we want to actually see happening, but the cynic in me know that if a company can save billions by skipping all trials and going straight to “dying human” they will, and they’d be happy to pay the expendable subject a million or even more, they still come out net positive.

If I was dying I'd rather be able to make a choice to my benefit rather than worrying about that it'd "be pretty" for onlookers.

There are certain choices we as a society do not want to allow you to make even if both you and the other party concents. Just because your dying and for instance would be ok with being hunted for sport in a Netflix special in return for a million dollar payout to your family does not mean we should forgoe all morals, logic and law and just accept it.

Allowing dying patients to make those sorts of deals with pharmaceuticals is just as horrible in the grander scale of things, they just stand to save a lot more costs and gain a lot more profits than Netflix would in a “Running Man” scenario.

You might be able to make an informed decision. Most people (and most doctors, for that matter), are not qualified to accurately judge the many uncertainties, biases and trade-offs present in drugs only tested in early stage clinical trials.

And to add on top of that. If pharmaceuticals could buy out dying patients at a fraction of a cost of even the pre clinical trials to get first human dose there would no longer be such a thing as “early stage clinical trials”

Such patients have opportunities to access experimental drugs, either in clinical trials, or through compassionate use waivers.

https://www.cancer.gov/about-cancer/treatment/drugs/access-e...

There's definitely a case to be made for early access to drugs for certain terminal illnesses in cases where there is compelling evidence that the drugs will pass Phase 3 trials. But, that should hardly be the 'default' as OP suggests.

Because it would degenerate into pharmaceuticals selling false hope in exchange for lab rats that are too far along to be saved even if the drugs work.

That being said I disagree with prescription pads. I should buy antibiotics for my kid without waiting four, five hours to be seen and processed

> I should buy antibiotics for my kid without waiting four, five hours to be seen and processed

Disagree. Antibiotics should not be taken lightly, especially by kids. Doctors have been far too liberal in prescribing them even when unnecessary and this has caused people to think antibiotics are to be taken like vitamins.

This antibiotic abuse causes issues that are out of scope to discuss here.

Which is why I get annoyed when Dr. prescribe them more liberally than I would; for things that they'll admit are probably viral.

But when a girl with a history of UTI is screaming in pain they come back with "Id rather wait for the cultures to come back"

No. Bugger off and give me the meds. I know my kid. I know what she has. And the culture confirms it three days layer every time.

The more we use antibiotics, the more opportunities there are for bacteria to evolve resistance.

So Ive been told.

And yet the Dr gives them out in exactly the same circumstances as I would if I could. Perhaps more liberally, since Im far more concerned about the consequences to my kids of destroying their gut flora.

Then the doctor is doing a bad job.

Making all antibiotics available over the counter would not improve the situation.

Im on my fifth (?) pediatrician. This one's the first one I even like as a person.

You said in a sister comment that your doctor wouldn't prescribe antibiotics until a culture came back. Isn't that precisely the opposite of giving them out freely in the same situations you would?

Yes, in your case the culture came back positive. But, you're not psychic, you didn't really know that, and you're biased by the fact it's your own child.

Do you know how many Dr.s a parent deals with? After hours, you don't go to your family Dr. This year alone Ive probably seen a dozen Dr.s

Ive had some Drs push antibiotics after they literally just said a persistent cough is probably viral.

Ive had my daughter with blood curdling screams told her urine came out negative and her urine would have to be cultured. They can culture it all they want but I didn't leave without the antibiotic. Guess how the cultures come out? Plural because it happened more than once and the quick test at the Dr. has a high false + rate. Btw, untreated UTIs cause scarring.

Btw, Dr. dont pearl clutch when it comes to their loved one. My colleague, who's married to a physician, got started on antibiotics for Lyme disease before the cultures came back positive. Just in case.

"But, you're not psychic, you didn't really know that,"

No, Im not. I just happen to have a neural network on the top of my head with hundred of millions (billions?) of years of evolution to spot trends.

It seems like you want to create a general rule entirely based on your own personal experience.

You are correct. I arrive at conclusions based on my life experiences and what I've learned along the way.

We literally give industrial quantities of antibiotics to animals. So antibiotic preservation is not an honest reason to lock them up

Tylenol and Advil can very quickly mess up your kid's liver and kidneys if you misdose. Yet, they're over the counter. So safety does not appear to be an honest reason either.

Ironically, statistically considering the forum, most ppl who are against me on this thread believe in drug liberalization including opiates; the one class for drugs I would keep behind the pharmacist's counter.

Btw, antibiotics are available over the counter in Europe. The ones Id use and feel comfortable using

> Btw, antibiotics are available over the counter in Europe. The ones Id use and feel comfortable using

What are you talking about?

> Over-the-counter (OTC) sales of antibiotics is forbidden by law in all countries, but it is allowed for some specific formulations (creams in Norway and Denmark or eye drops in the UK)

https://www.escmid.org/escmid_publications/escmid_elibrary/m...

You're right; since I last visited Greece they've tightened their antibiotic policy (2020).

> We literally give industrial quantities of antibiotics to animals. So antibiotic preservation is not an honest reason to lock them up

We desperately need to stop doing that too, but at least it optimizes for bacteria that infects animals rather than humans.

I don't think you (and most other people) are anywhere near scared enough of returning to a world without antibiotics.

"optimizes for bacteria that infects animals rather than humans."

But then there is horizontal gene transfer.

The world has a lot to be scared of. Ive had an easy life, save for one or two experiences that have dwindled what truly frightens me a lot:

- Dying after my kids (unless my kids have a tremendous disability. Then my fear is reversed)

- Facing God, if He exists. If He doesn't, the nothingness of space.

Pain was on the list, but a bone marrow biopsy knocked it off. A world without modern antibiotics doesn't scare me. Much anyway.

> Because (at least) for people with a high risk of dying

and who decides that?

Can a drug company give "gifts" to doctor who then recommend the patient use that company's drugs when he/she is dying?